Irish Examiner view: Alzheimer’s drug brings hope for many

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The trial shows the first time any drug has been able to indicate a change in the trajectory of Alzheimer's.

Amid this week’s sea of troubles, rolling endlessly to the horizon, it was easy to miss the importance of a scientific news item. It was described as an “historic moment” and, given the experience that some of us have, and will have, it is certainly that.

Alzheimer treatment trials carried out jointly by the Tokyo-based company Eisai, and the Cambridge, Massachusetts, pharma giant Biogen show that cognitive decline was 27% less in early-stage patients treated with lecanemab than others who received a placebo. 

This is the first time that any drug has been able to indicate a change in the trajectory of the disease.

The Alzheimer’s Society of Ireland’s current estimate is that there are 64,000 people with dementia in the Republic. 

As two thirds of them live at home this means that some 200,000 people are involved in providing support. It calculates that the overall cost of care is just over €1.69bn per annum; 48% of this is attributable to family care and 43% is accounted for by residential care.

Some estimates say that Ireland will have more than 142,000 patients by 2050, greater than the Western European average, and the highest level of modelling produces 170,000 cases.

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Worldwide, the number of sufferers and potential sufferers runs into many millions so, by any yardstick, this could represent a hugely significant breakthrough.

The director of Alzheimer’s Research in the UK, Dr Susan Kolhaas, commented: “This is a historic moment for dementia research, as this is the first phase 3 trial of an Alzheimer’s drug in a generation to successfully slow cognitive decline. Many people feel Alzheimer’s is an inevitable part of ageing.

“This spells it out: If you intervene early, you can make an impact on how people progress.” 

We have waited a long time for a glimmer of hope in this field of medicine. Eisai and Biogen are expected to apply for regulatory approval in the US and Europe by the end of the year.

Then there will be difficult decisions to be made. Who will fund the drug? Who will be eligible for it? Is there production capacity to deliver it? Will results be even better if intervention takes place earlier?

Medical solutions do not leap fully formed into existence. 

Even the seemingly miraculous arrival of coronavirus vaccines depended on years of diligent work and research. But this is a beginning, and we should welcome and applaud it.